Tam says there are situations where wearing a homemade mask outside is 'a good idea'

TORONTO --
In the wake of the U.S. Centre for Disease Control recommending that all Americans start wearing homemade cloth face masks outside due to COVID-19, many Canadian doctors and officials are saying cloth masks are recommended in certain situations, though Canada’s top doctor has stopped short of officially calling for facial coverings.

Chief public health officer Dr. Theresa Tam said Saturday that Canada, “like the United States, (is) looking at the latest information and looking at recommendations right now.”

As officials have stressed from the beginning, Tam repeated that medical masks need to be reserved for healthcare workers, pointing out the country’s supply of personal protective equipment is low.

Officials in Canada have been wary of recommending masks, wanting the public to focus on the essential measures of physical distancing and frequent washing of hands.

But the messaging has begun to shift to include a place for homemade masks.

Tam said Saturday that there are scenarios in which she believes a homemade facial covering of some type — one that would not count as medical equipment needed by doctors — could be beneficial.

"For example, if you’re in public transit and you cannot easily practice the two metres (of physical distancing), for example, then having that additional covering, like covering up your cough, I think, is a good idea,” she said.

She emphasized that distance from each other is the most important thing. But if that distance is not possible, or is difficult, then “having an additional covering and a barrier to prevent you from spreading droplets to others … is a reasonable thing to do.”

This marks a shift in Tam’s advice on the topic. On Monday, she said she was concerned that wearing masks might tempt people to touch their faces more often, and potentially increase the risk of infection.

Homemade masks refer to any mask or facial covering that can be easily made using supplies around the house, including t-shirts, pant legs, handkerchiefs, bandanas or any type of scrap fabric. Online tutorials have grown increasingly popular as the public looks for ways to be proactive during the pandemic.

U.S President Donald Trump announced the new CDC guidelines on Friday, explaining that it was a voluntary recommendation. He has said that he will not wear a mask himself.

A page on the CDC’s website goes over how to wear a cloth face covering, how to wash one (they say a washing machine will do), and how to remove one safely.

The CDC instructions specify that you should not touch your eyes, nose and mouth when removing a mask, and you should wash your hands immediately.

They also have three different tutorials on how to make a cloth face mask, ranging from a sewing tutorial to a no-sew method that requires nothing more than a bandana and two hair elastics.

Tam is not the only Canadian official softening towards the use of cloth masks for civilians.

On Friday, only hours after Alberta Health Services said healthy Albertans were not advised to wear masks of any type, chief medical officer of health Dr. Deena Hinshaw said in her daily briefing that masks could be helpful to curb asymptomatic spread.

Hinshaw said that masks are more helpful for the sick to wear than the healthy, because a mask could catch the droplets from a cough. But she added that there is evidence that “a small proportion of people with COVID spread the virus before they have symptoms.”

In the light of this knowledge, she said, there is an argument that those with no symptoms could use homemade masks as a preventative.

The debate over whether some type of facial covering is medically necessary or not has raged on for weeks, with mixed statements from health officials leaving the public confused as to what to do.

Infectious disease specialist Dr. Ronald St. John, who is the former federal manager to the SARS response in Canada, told CTV News Channel that he thinks some of the confusion comes from people being uncertain which types of masks are being talked about.

He said he thinks of the problem in three categories: respirator, surgical and homemade.

The N95 and equivalent respirator masks are “a truly protective mask,” he said, and should be reserved for healthcare workers “because it does protect them when it’s properly fitted and properly used.”

Surgical masks were invented not to protect surgeons, he said, but to prevent surgeons from coughing or sneezing into their patients’ open wounds. Essentially, the goal of a surgical mask is to protect everyone else from the person wearing the mask.

Homemade cloth masks operate on the same principle as surgical masks — they can help stop a wearer from spraying droplets on others when sneezing or coughing, but do not promise any protection from the virus for the person wearing them, St. John explained.

“Right now, with (there being) more interest in the person who has no symptoms who might be a spreader, people who have mild symptoms and are about to get sick who may not recognize that (they can) be a spreader — having a mask on those people would help reduce transmission of the virus,” St. John said.

When it comes to masks, at least one directive from officials that has remained clear from the start: the general public should leave surgical masks and respirators for healthcare and front line workers.

Emergency physician Dr. Kashif Pirzada works in Toronto and has been running volunteer donation drives for protective personal equipment so that doctor’s offices don’t have to close.

He told CTV News Channel that at one of the sites where he works, “you get one (surgical) mask assigned to you for the day. We’re starting to run out.”

He added that N95 respirator masks are also running low. In the days of SARS, he said, he had to wear an N95 mask — which are more effective protection than the basic surgical masks — all day in the hospital.

“Now there’s not enough of these … for anyone except people doing the most dangerous procedures,” he said.

Pirzada said that he’s aware that “the advice has been evolving on wearing masks in public.”

In his mind, homemade cloth masks are a good idea for the public, because they will “keep droplets from flying out of your mouth and hitting other people.”

He said that while cloth masks “won’t necessarily protect” the wearer, he pointed out that “if everyone wears (one), everyone’s protected.”

Officials stress that if you are wearing a homemade mask outside, you should not let it give you a false sense of security. Wearing a cloth mask doesn’t suddenly make it safer to be loose on physical distancing guidelines.

“Wearing a mask may be useful as an (add on) to the other elements,” St. John said. “Wash your hands and (practice) physical distancing. Those are the key elements.”